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Intended for Healthcare Professionals
British Journal of General Practice

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Research Article

Outcome of general practitioner referrals to specialist outpatient clinics for back pain.

A Coulter, J Bradlow, C Martin-Bates, M Agass and A Tulloch
British Journal of General Practice 1991; 41 (352): 450-453.
A Coulter
Health Services Research Unit, University of Oxford.
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J Bradlow
Health Services Research Unit, University of Oxford.
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C Martin-Bates
Health Services Research Unit, University of Oxford.
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M Agass
Health Services Research Unit, University of Oxford.
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A Tulloch
Health Services Research Unit, University of Oxford.
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Abstract

In 1983-84 general practitioners in the Oxford region kept records of their referrals to outpatient clinics over a period of six months. Five years later in 1988-89 the general practice notes of 182 patients referred for back pain were studied to determine the outcomes of their referral. The actions initiated in the outpatient clinics were compared with the general practitioners' main reason for referral recorded at the time of referral. Of the 182 patients 136 (74.7%) received specialist treatment following the outpatient referral despite the fact that general practitioners had given treatment as the main reason for referral in only 28.6% of cases. Patients' mean consultation rate for back pain declined from 4.2 consultations per annum to 0.9 (P less than 0.001) over the five year period, but there was a small but significant increase in consultations for other problems. Five years after the referral 33.3% of patients were still consulting their general practitioner for back pain. The referral system for patients with chronic back pain could be rationalized to reduce the need for re-referrals and multiple follow-up outpatient consultations. There is a need to improve communications between general practitioners, specialists and patients about the purpose of referral, the likely effects of treatment and the scope for prevention. A survey of the outcome of referrals for common conditions, such as back pain, is a useful first step in the development of referral guidelines.

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British Journal of General Practice: 41 (352)
British Journal of General Practice
Vol. 41, Issue 352
November 1991
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Outcome of general practitioner referrals to specialist outpatient clinics for back pain.
A Coulter, J Bradlow, C Martin-Bates, M Agass, A Tulloch
British Journal of General Practice 1991; 41 (352): 450-453.

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Outcome of general practitioner referrals to specialist outpatient clinics for back pain.
A Coulter, J Bradlow, C Martin-Bates, M Agass, A Tulloch
British Journal of General Practice 1991; 41 (352): 450-453.
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Print ISSN: 0960-1643
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